Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

Rao, Goutham; Powell‐Wiley, Tiffany M.; Ancheta, Irma B.; Hairston, Kristen G.; Kirley, Kate; Lear, Scott A.; North, Kari E.; Palaniappan, Latha; Rosal, Milagros C.

doi:10.1161/cir.0000000000000223

Cited by 133 publications

(101 citation statements)

References 120 publications

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“…However, it is expansion more specifically of the intra-abdominal adipose tissue that reflects the dyslipidemic, hormonal, and inflammatory features that constitute dysfunctional adiposity. 5,7,38–40 SADHtR is presumably the better estimator of expanded intra-abdominal adipose tissue. By contrast, WHtR also incorporates an estimate of the abdominal subcutaneous adipose tissue, which generally performs relatively benign functions.…”

Section: Discussionmentioning

confidence: 98%

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Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders

Kahn¹,

Bullard²

2016

The American Journal of Medicine

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BACKGROUND The clinical recognition of cardiometabolic disorders might be enhanced by anthropometry based on the sagittal abdominal diameter (SAD; also called “abdominal height”) or waist circumference rather than on weight. Direct comparisons of body mass index (BMI, weight/height2) with SAD/height ratio (SADHtR) or waist circumference/height ratio (WHtR) have not previously been tested in nationally representative populations. METHODS Nonpregnant adults without diagnosed diabetes (ages 20–64 years; n = 3071) provided conventional anthropometry and supine SAD (by sliding-beam caliper) in the 2011–2012 US National Health and Nutrition Examination Survey. Population-weighted, logistic models estimated how strongly each anthropometric indicator was associated with 5 cardiometabolic disorders: Dysglycemia (glycated hemoglobin ≥5.7%), HyperNonHDLc (non-high-density-lipoprotein [HDL] cholesterol ≥4.14 mmol/L, or taking anticholesteremic medications), Hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or taking antihypertensive medications), HyperALT (alanine transaminase ≥p75 [75th percentile, sex-specific]), and HyperGGT (gamma-glutamyltransferase ≥p75 [sex-specific]). RESULTS After scaling each indicator, adjusted odds ratios (aORs) tended to be highest for SADHtR and lowest for BMI when identifying each disorder except dysglycemia. When SADHtR entered models simultaneously with BMI, the aORs for BMI no longer directly identified any condition, whereas SADHtR identified persons with HyperNonHDLc by aOR 2.78 (95% confidence interval [CI], 1.71–4.51), Hypertension by aOR 2.51 (95% CI, 1.22–5.15), HyperALT by aOR 2.89 (95% CI, 1.56–5.37), and HyperGGT by aOR 5.43 (95% CI, 3.01–9.79). WHtR competed successfully against BMI with regard to Dysglycemia, Hyper-NonHDLc, and HyperGGT. c-Statistics of SADHtR and WHtR were higher than those of BMI (P <.001) for identifying HyperNonHDLc and HyperGGT. CONCLUSIONS Among nonelderly adults, SADHtR or WHtR recognized cardiometabolic disorders better than did the BMI.

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Section: Discussionmentioning

confidence: 98%

“…3 Some authorities recommend that the waist circumference be added to BMI as a primary tool for assessing adiposity. 4,5 …”

mentioning

confidence: 99%

Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders

Kahn¹,

Bullard²

2016

The American Journal of Medicine

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“…On the basis of students' medical history, children who reported a previous diagnosis of overt heart, renal, lung and liver diseases, asthma or physical/mental deformities were excluded (19) . As Asian populations and other populations, including blacks and Hispanics, may have different growth patterns and fat accumulations (20) , the BMI references for screening Chinese Children with overweight and obesity were used in children in this study (online Supplementary Table S1) (21) . In this study, 796 children (486 boys and 310 girls) identified as overweight or obese were recruited.…”

Section: Participantsmentioning

confidence: 99%

The importance of blood lipids in the association between BMI and blood pressure among Chinese overweight and obese children

et al. 2016

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We aimed to examine the contribution of blood lipids to the association between BMI and blood pressure (BP) in children with overweight and obesity. Data were collected in elementary and high schools of Chaoyang District, Beijing, China in 2012. Participants' weight, height, BP and fasting plasma lipid profile were measured by standard protocols. Mediation analysis was used to examine the mediation role of blood lipids on the relation between BMI and BP, with age included as a covariate. We found that in boys 8·29 % (mediation effect = 0·106, P = 0·012) of the association between BMI and systolic BP was mediated through TAG. TAG mediated 12·53 % (mediation effect = 0·093, P = 0·018) and LDL-cholesterol mediated 7·75 % (mediation effect = 0·57, P = 0·046) of the association between BMI and diastolic BP was mediated by TAG and LDL-cholesterol, respectively. However, blood lipids did not show the mediation effect in girls. Our findings suggested that there was a sex difference in the contribution of blood lipids to the association between BMI and BP. Controlling TAG or LDL-cholesterol may be beneficial for reducing the risk of the BMI-related high BP in overweight boys; however, this outcome is not the case when controlling TAG or LDL-cholesterol in girls. This study may provide clues to explore the underlying mechanism of the association between obesity and hypertension.

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“…Inactivity and sedentary behaviors contribute to ~5.3 million deaths annually (Katzmarzyk and Janssen 2004;Lee et al 2015;Ogden et al 2014;Rao et al 2015). A significant proportion of these deaths are due to complications from type 2 diabetes (T2D) and the insulin resistance syndrome that precedes it (Cowie et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Genetic characterization of physical activity behaviours in university students enrolled in kinesiology degree programs

Many

Kendrick

Deschamps

et al. 2017

Appl. Physiol. Nutr. Metab.

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Studies of physical activity behaviours have increasingly shown the importance of heritable factors such as genetic variation. Non-synonymous polymorphisms of alphaactinin 3 (ACTN3) and the β-adrenergic receptors 1 and 3 (ADRB) have been previously associated with exercise capacity and cardiometabolic health. We thus hypothesized that these polymorphisms are also related to physical activity behaviors in young adults. To test this hypothesis we examined relationships between ACTN3 (R577X), ARDB1 (Arg389Gly) and ADRB3 (Trp64Arg), and physical activity behaviors in university students. We stratified for student enrollment in kinesiology degree programs compared to non-majors as we previously found this to be a predictor of physical activity. We did not identify novel associations between physical activity and ACTN3. However, the minor alleles of ADRB1 and ADRB3 were significantly underrepresented in kinesiology students compared to non-majors. Furthermore, carriers of the ADRB1 minor allele reported reduced participation in moderate physical activity and increased afternoon fatigue compared to ancestral allele homozygotes. Together, these findings suggest that the heritability of physical activity behaviours in young adults may be linked to nonsynonymous polymorphisms within β-adrenergic receptors.

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Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

Cited by 133 publications

References 120 publications

Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders

Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders

The importance of blood lipids in the association between BMI and blood pressure among Chinese overweight and obese children

Genetic characterization of physical activity behaviours in university students enrolled in kinesiology degree programs

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